Cannabis Mobile Apps: a Content Analysis

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JMIR MHEALTH AND UHEALTH Ramo et al

Original Paper Cannabis Mobile Apps: A Content Analysis

Danielle E Ramo1, PhD; Lucy Popova2, PhD; Rachel Grana2, MPH, PhD; Shirley Zhao1, BA; Kathryn Chavez1, BA 1Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States 2Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, United States

Corresponding Author: Danielle E Ramo, PhD Department of Psychiatry University of California, San Francisco 401 Parnassus Avenue Box TRC 0984 San Francisco, CA, 94143 United States Phone: 1 415 476 7695 Fax: 1 415 476 7053 Email: [email protected]

Abstract

Background: Mobile technology is pervasive and widely used to obtain information about drugs such as cannabis, especially in a climate of rapidly changing cannabis policy; yet the content of available cannabis apps is largely unknown. Understanding the resources available to those searching for cannabis apps will clarify how this technology is being used to reflect and influence cannabis use behavior. Objective: We investigated the content of 59 cannabis-related mobile apps for Apple and Android devices as of November 26, 2014. Methods: The Apple and Google Play app stores were searched using the terms ªcannabisº and ªmarijuana.º Three trained coders classified the top 20 apps for each term and each store, using a coding guide. Apps were examined for the presence of 20 content codes derived by the researchers. Results: Total apps available for each search term were 124 for cannabis and 218 for marijuana in the Apple App Store, and 250 each for cannabis and marijuana on Google Play. The top 20 apps in each category in each store were coded for 59 independent apps (30 Apple, 29 Google Play). The three most common content areas were cannabis strain classification (33.9%), facts about cannabis (20.3%), and games (20.3%). In the Apple App Store, most apps were free (77%), all were rated ª17+º years, and the average user rating was 3.9/5 stars. The most popular apps provided cannabis strain classifications (50%), dispensary information (27%), or general facts about cannabis (27%). Only one app (3%) provided information or resources related to cannabis abuse, addiction, or treatment. On Google Play, most apps were free (93%), rated ªhigh maturityº (79%), and the average user rating was 4.1/5. The most popular app types offered games (28%), phone utilities (eg, wallpaper, clock; 21%) and cannabis food recipes (21%); no apps addressed abuse, addiction, or treatment. Conclusions: Cannabis apps are generally free and highly rated. Apps were most often informational (facts, strain classification), or recreational (games), likely reflecting and influencing the growing acceptance of cannabis for medical and recreational purposes. Apps addressing addiction or cessation were underrepresented in the most popular cannabis mobile apps. Differences among apps for Apple and Android platforms likely reflect differences in the population of users, developer choice, and platform regulations.

(JMIR mHealth uHealth 2015;3(3):e81) doi: 10.2196/mhealth.4405

KEYWORDS cell phones; mobile apps; cannabis

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recommended guidelines. There has not been a content analysis Introduction of mobile apps related to cannabis use, and it is unclear whether Cannabis is the most widely used illicit substance in the United available apps address addiction or cessation at all. States, with 19.8 million US residents (7.5%) age 12 or older Other content analyses have evaluated the scientific rigor of reporting past-month use in 2013 [1]. In 2012, the prevalence health-related mobile apps. Cowan et al [13] found that iPhone of cannabis use surpassed that of cigarette smoking among youth apps targeting physical activity were generally lacking in age 12 to 17, and this continued into 2013 and 2014 [1,2]. theoretical content, and higher-priced apps and those that Cannabis use and its legalization are contested issues, as policy addressed a broader activity spectrum incorporated more changes have led to increases in the availability of cannabis for theoretical content. In an evaluation of iPhone diet apps, West medical and recreational use in the United States, and problems et al [14] found most apps to be theory deficient and provide associated with using cannabis (eg, diagnoses of cannabis use only general information or assistance. Breton and colleagues disorder) [3]. Cannabis remains a Schedule I substance under similarly concluded that only a small fraction (15%) of apps US federal law; however, two US states have legalized retail for weight control adhered to 5 or more of 13 practices cannabis, two additional states and the District of Columbia recommended by government agencies for the control of weight have passed legislation to legalize use, and 33 states and Guam [15]. Content analysis of apps for pediatric obesity prevention have legalized medical cannabis use. These state-level policy (weight loss, healthy eating, physical activity) found that most changes in the United States and the continued tension between apps (62%) lacked any expert recommendations, and those that federal and state laws have led to a proliferation of did were limited in the number of recommendations made (mean cannabis-related information in the United States and across 3.6, SD 2.7 out of 15 defined guidelines). More than half (56%) the world. of the apps were games, consistent with strategies appealing to Mobile technology, including the mobile phone, has been a young people [16]. Other reviews showed a similar lack of vehicle for cannabis-related news and information. With a global comprehensive, scientific information for asthma management audience totaling up to 1.75 billion in 2014, mobile phone [17], and variance in adherence to established guidelines for technology is pervasive and widely used [4]. Mobile phones first aid by source [18] and for cancer information by target have revolutionized mobile communication technology through audience (health care professionals vs the public) [19]. Results the availability of Internet access. Mobile phones also allow of these studies highlight that, although the material is vast, users to download apps, which are programs designed there is a lack of information with scientific grounding or specifically for mobile phone operating systems. In June 2014, theory-based interventions available to users. Apple announced that 75 billion apps had been downloaded A report of young adults' perspectives on apps for health from its App Store for the iPhone/iPad [5], and a June 2014 behavior change showed that young adults have an interest in report showed that downloads from Google Play for Android using such apps, and that accuracy, legitimacy, security, effort devices had reached roughly 80 billion [6]. Market research required, and immediate effects on mood were important firms have estimated that in 2015, there will be nearly 3 billion influences on app usage [20]. It is unclear whether mobile apps devices running the Android operating system and 500 million for cannabis use address health behavior change in any way. running the Apple operating system (iOS) worldwide [6]. Given widespread cannabis use, political controversy People are increasingly turning to mobile phones to get surrounding its legalization, and the potential for mobile information about potential health risk behaviors such as technology to deliver information about cannabis to a large cannabis use. A majority of users (52% of Americans) use their body of users worldwide, there is a need to understand the nature mobile phones to gather health-related information [7]. of available cannabis information on mobile phones. This study However, it is unclear what is available to them when they do analyzed the top cannabis-related mobile apps on Apple's App seek out this information. Store and Google Play in terms of app characteristics (price, rating, download range) and content codes (strain classification, Some previous work has characterized the content of mobile laws, games, social media, medicinal use, etc). Findings will apps related to substance use. A review of 384 alcohol-related inform how cannabis is portrayed in the context of mobile apps, apps available on Apple's App Store and Google Play found describe what (if any) health information is conveyed in that the majority of apps were primarily for entertainment (50%) cannabis apps, and highlight gaps in available information. or claimed to provide a blood alcohol concentration (39%), and the latter apps were highly unreliable. Only 11% of apps Methods supported the safety of reduction/cessation of drinking [8]. A review of 87 addiction apps on Google Play in 2012 found that Identifying Cannabis Apps apps typically provided information on recovery, content to We used several strategies to identify apps that would be most enhance motivation and promote social support, and tools to likely encountered by users seeking cannabis-related monitor progress [9]. Abroms and colleagues conducted two information. First, a search for the most commonly used words reviews of mobile apps for tobacco cessation, and concluded for ªcannabisº was performed at the website that these apps generally do not adhere to US Clinical Practice UrbanDictionary.com in January 2014. A total of 110 commonly Guidelines for smoking cessation [10,11]. Jacobs and colleagues used and slang terms were listed, and used as search terms on [12] classified Facebook apps for smoking cessation, similarly Apple's App Store and Google Play. At the time of searching, concluding that the few available apps had low adherence to Google Play reported up to 250 apps for each term and all terms

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had 250 results. On Apple's App Store, the number of results from .71 (facts) to 1.00 (all other categories), indicating strong differed widely by search term. Terms with meanings other than reliability. strictly cannabis (eg, ªbomb,º ªzombie,º ªpotº) had more results than those referring primarily to cannabis (eg, ªmarijuanaº). Coding Guide The first, second, and third authors made a decision not to use The final guide included coding for basic information about terms that could refer to something other than cannabis, and app compatibility (eg, type of mobile phone, version of operating used the frequency of search results for all remaining terms to system required for use), and basic description of the app based inform the final choice to use the terms ªcannabisº and on information reported by Apple's App Store or Google Play ªmarijuanaº for the content analysis. (name of the app, URL, age restriction based on Apple's App Store or Google Play categories, average user ratings based on A search for apps using the keywords ªmarijuanaº and Apple's App Store or Google Play ratings, total app installs ªcannabisº was then performed on Apple's App Store and [Google Play only], and any exact fees for app use). Categories Google Play on November 26, 2014. The first 20 results for of apps as specified by Apple's App Store or Google Play were either search term in both stores were considered for coding. also coded. Explanations of Apple App Store categories were Any app that did not duplicate a previous result was coded for available online [23]. No description of categories was available content. Only the first 20 results were chosen for analysis based for Google Play. on consensus among investigators that users rarely go beyond the first 1-2 screens in app stores, a rationale similar to that used Each mobile app was coded for the presence of each of the in a content analysis of electronic cigarette websites [21]. The following content codes: (1) Utilities (including phone total number of apps analyzed in this exploratory project was wallpaper, battery widget, backgrounds, clock widget, weather comparable to previous reviews of tobacco smoking cessation widget, brightness widget, toggle widgets [wifi, sound, apps that included 47 [10] and 98 apps [11], and a review of 12 auto-rotate, data], unit converter weight scale); (2) News Facebook apps for smoking cessation [22]. (cannabis-related); (3) Social Media (apps allowing for connection with other users); (4) Medicinal Use (connection Coding Guide Development with doctors who prescribe medicinal cannabis); (5) Recipes In January 2014, a research staff member, supervised by the for cooking with cannabis; (6) Games (cannabis-themed); (7) first author, searched the Apple App Store and Google Play Cannabis Strain Classification (pictures, videos, information store using the term ªmarijuanaº and selected the top 10 apps about the effects of each strain, ability to upload pictures of in each store (20 apps total) to develop a coding guide, similar cannabis); (8) Information on Growing Cannabis (eg, to the procedure used by Grana and Ling [21] for electronic information on seed fermentation or ideal growing conditions); cigarette websites. The staff first drafted a guide relevant to (9) Dispensaries (medical or recreational, global vs specific cannabis apps, including prompting for all features included on region, contacting a dispensary, offer of discounts for dispensary the Apple App Store and Google Play, and content codes. In products); (10) Laws pertaining to cannabis (including in any March 2014, a coder who did not participate in the final coding US state or another geographic region); (11) Cannabis Social process for the analysis again selected a sample of top 10 apps Gatherings (descriptions, directions to cannabis events); (12) from each store using the search term ªmarijuanaº (for a total Cannabis Cup results; (13) Cannabis Smoking Etiquette (eg, of 20 apps), coded them and further revised the coding guide. ªhowº to smoke, things not to do); (14) Cannabis Dictionary; The top apps listed for searches change quickly; therefore, the (15) Facts about cannabis; (16) Cannabis Abuse, Addiction or apps that were in the top search results during the coding guide Treatment; (17) Virtual Simulation (eg, smoking a virtual joint, development may not have been in the top results at the time realistic joint rolling); (18) Log of cannabis use (record of of the final content analysis. previously tried marijuana/cannabis strains and/or flavors, daily use of joints/blunts, and/or daily growth of marijuana/cannabis Throughout the coding guide development process, the guide plants); (19) Cannabis Jokes; and (20) Cannabis Quotes. A was reviewed iteratively by the first three authors, refined, and single app could include any number of categories. Examples retested to generate consistent definitions and examples. of each content code are listed in Table 2, and screenshots of In March 2014, 2 coders were trained by the first author and a sample apps are in Multimedia Appendix 1. sample of apps were coded and evaluated for reliability. Twenty apps (10 Apple's App Store, 10 Google Play, not necessarily Data Analysis included in the final sample) resulting from the search term We calculated the frequency of results from each search term ªmarijuanaº were used for training, and reliability with Kappa related to cannabis and determined the best search terms for ranged from .62 (medicinal use) to .89 (news). Any content coding. Once coding was completed, we calculated discrepancies in coding were discussed with the first author and frequencies and used descriptive statistics to characterize apps. a consensus was reached. After reliability was established, apps Microsoft Excel was used for all analyses. meeting search criteria for the main analysis (search terms ªcannabisº and ªmarijuanaº) were divided and given to the Results same 2 coders. Coders downloaded all free and paid apps to examine features. In November 2014, a third coder downloaded Content Analysis and coded all 59 apps reported in this analysis. Reliability for Total apps available for each search term were 124 for the 8 apps that were the same on Apple's App Store under the ªcannabisº and 218 for ªmarijuanaº on Apple's App Store, and search term ªcannabisº in March and November 2014 ranged 250 each for ªcannabisº and ªmarijuanaº on Google Play.

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Within the top 20 apps for each search term (ªcannabisº and On Apple's App Store, most apps were free (77%), all were ªmarijuanaº) in each store, there were 10 duplicates on Apple's rated for users aged ª17+º years, and the average rating was App Store and 11 duplicates on Google Play. Thus, 59 3.9/5 stars. On Google Play, most apps were free (93%), rated independent apps (30 on Apple's App Store, 29 on Google Play) ªhigh maturityº (79%), and the average rating was 4.1/5 stars. were coded (see Appendix 2 for a complete list). The modal range of downloads was 100,000-500,000 (34%; Table 1).

Table 1. Overview of mobile cannabis/marijuana apps (N=59). Category All Apple App Store Google Play (N=59) (n=30) (n=29) Free, n (%) 50 (85) 23 (77) 27 (93)

Average pricea (SD) $2.43 (0.88) $2.56 (0.79) $1.99 (1.41) Average user rating (SD) 4.0 stars (0.64) 3.9 stars (0.94) 4.1 stars (0.31)

Type of app b, n (%) Lifestyle 17 (29) 12 (40) 5 (17) Medical 11 (19) 9 (30) 2 (7) News (App Store)/ news & magazines 3 (5) 2 (7) 1 (3) (Google Play) Games 11 (19) 4 (13) 7 (24) Reference (App Store)/books & refer- 5 (9) 2 (7) 3 (10) ence (Google Play) Health & fitness 3 (5) 1 (3) 2 (7)

Personalizationc N/A N/A 6 (21)

Educationc N/A N/A 1 (3)

Entertainmentc N/A N/A 2 (7) Age restriction/maturity level, n (%) 17+ N/A 30 (100) N/A High maturity N/A N/A 23 (79) Medium maturity N/A N/A 6 (21)

Total installs d, n (%) 1000-5000 N/A N/A 2 (7) 5000-10,000 N/A N/A 2 (7) 10,000-50,000 N/A N/A 6 (21) 50,000-100,000 N/A N/A 2 (7) 100,000-500,000 N/A N/A 10 (34) 500,000-1,000,000 N/A N/A 5 (17) 1,000,000-5,000,000 N/A N/A 2 (7)

aAverage price calculated for only those apps with any cost. bType of app as specified by Apple's App Store or Google Play. cCategory only present on Google Play. d Installs information only present on Google Play. Based on our coding, the three most common content codes information or resources related to cannabis abuse, addiction, across all apps were cannabis strain classification (33.9%), facts or treatment. On Google Play, the most popular apps offered about cannabis (20.3%), and games (20.3%). On Apple's App games (28%), phone utilities (eg, wallpaper, clock; 21%) and Store, the top 20 apps provided cannabis strain classifications cannabis food recipes (21%); no apps addressed abuse, (50%), dispensary information (27%), or general facts about addiction, or treatment. cannabis (27%; Table 2). Only one app (3%) provided any

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Table 2. Content codes of mobile cannabis apps (N=59). Example All, n (%) Apple App Store, n (%) Google Play, n (N=59) (n=30) (%) (n=29) Strain classification Leafly Marijuana Strain and Dispensary Reviews 20 (34) 15 (50) 5 (17) (App Store and Google Play)Ðcontains a database of hundreds of marijuana strains and their effects, flavors, medical treatment, and availability nearby Facts Marijuana Facts (Google Play)Ða collection 12 (20) 8 (27) 4 (13) of marijuana-related facts pertaining to consump- tion, cultivation, production, history, and sustain- ability Game Pot Farm - Grass Roots (Google Play)Ðgrow 12 (20) 4 (13) 8 (28) and sell virtual weed Dispensaries Weedmaps (App Store and Google Play)Ðhelps 10 (17) 8 (27) 2 (7) users connect to local dispensaries and access menus, strain reviews, and exclusive offers Recipes Weed Cookbook - Medical Marijuana Recipes 10 (17) 4 (13) 6 (21) & Cooking (App Store)Ða collection of recipes that include cannabis as an ingredient News Cannabis News Pro (App Store)Ða collection 9 (15) 6 (20) 3 (10) of cannabis-related news from multiple sources Utilities Cannabis Joint Battery Widget (Google 9 (15) 3 (10) 6 (21) Play)Ðshows phone's battery level as a burning joint Growing cannabis Cannabis Pocket Reference (Google 8 (14) 4 (13) 4 (14) Play)Ðcontains a Grow Guide with growing information, pest/disease control tips, grow di- ary, and nutrient charts Social media Rate My Weed - The First Ever Marijuana 8 (14) 6 (20) 2 (7) Recognition Software (App Store)Ðallows users to share marijuana recognition results on Face- book and Twitter Laws WeedLaws: Marijuana Law Guide (Google 7 (12) 4 (13) 3 (10) Play)Ðprovides state-specific legal information regarding use, possession, cultivation, and sale of cannabis Medicinal use Marijuana - MyGreenz Locator (App 7 (12) 5 (17) 2 (7) Store)Ðconnects users to medical marijuana doctors and dispensaries Cannabis cup Cannabis Cups (App Store)Ðallows users to 5 (9) 4 (13) 1 (3) view and judge featured strains, gives directions to Cannabis Cup events, and includes Cannabis Cup results from previous years Log Medical Marijuana Log (App Store)Ðallows 5 (9) 4 (13) 1 (3) users to record daily cannabis use via blunts, joints, vapes, bowls, or dabs Dictionary Marijuana 420 (App Store)Ðdictionary of 3 (5) 3 (10) 0 marijuana-related terms, street names, and slang Quotes Marijuana Quotes (Google Play)Ðcollection of 3 (5) 0 3 (10) marijuana-related quotes Smoking etiquette Joint 4 Dummies (Google Play)Ðteaches users 3 (5) 2 (7) 1 (3) several ways to roll a joint Social gatherings Cannabis Culture (Google Play)ÐCanadian- 3 (5) 2 (7) 1 (3) based magazine that covers cannabis cultural events such as the Global Marijuana March and 420

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Example All, n (%) Apple App Store, n (%) Google Play, n (N=59) (n=30) (%) (n=29) Virtual simulation iSmoke: Weed HD - Free (Google Play)Ða 2 (3) 0 2 (7) simulation of rolling and lighting a joint while listening to a soundtrack Abuse, addiction, or treatment Marijuana Anonymous Mobile (App Store)Ð12- 1 (2) 1 (3) 0 step guide to recovering from marijuana addiction, includes addiction-related literature and a meeting search function to connect users Jokes Marijuana Jokes (Google Play)Ðcollection of 1 (2) 0 1 (3) marijuana-related jokes

On Apple's App Store, the app that appeared as the top result Only one app addressed cannabis abuse, addiction, or treatment for both search terms (ªcannabisº and ªmarijuanaº) was Leafly in any way. On Apple's App store, Marijuana Anonymous Marijuana Strain and Dispensary Reviews. It featured a large Mobile employed a 12-step recovery program, analogous to the database of strain reviews (with pictures, flavors, effects, etc), 12-Step Recovery Program of Alcoholics Anonymous, to help a ªFinderº function to locate and review nearby dispensaries users stop cannabis use. The app contained information (medical or recreational), and an information section with regarding addiction and recovery, including a monthly cannabis-related news and content. The app was free and had newsletter and an interactive 12-Step Workbook. It offered a an average user rating of 5 stars. This app was given 5 content chat feature and a meeting search function that allowed users codes: News, Medicinal Use, Strain Classification, Dispensaries, to find in-person, phone, and online meetings. It also included and Facts. a Sobriety Date Counter that allowed users to record the number th The app that appeared as the second result for both search terms of days of abstinence. The app was listed as the 17 result under in Apple's App Store was Marijuana Handbook Lite - The the search term ªmarijuana,º was free, and had an unknown Ultimate Medical Cannabis Guide With The Best of Edible, user rating. This app was given 2 content codes: Abuse, Ganja Strains, Weed Facts, Bud Slang and More! The app Addiction, or Treatment and Facts. featured a wide range of cannabis-related resources, including a strain library, a maps section to locate medical or recreational Discussion dispensaries, a marijuana dictionary, a facts section, and a cookbook. The app was free and the average user rating was Principal Findings unknown. This app was given 6 content codes: Recipes, Strain This study examined 59 mobile apps related to cannabis. Over Classification, Dispensaries, Smoking Etiquette, Dictionary, half (58%) of the top apps on Google Play had been downloaded and Facts. at least 100,000 times, showing that mobile users are generally interested in this category of apps. Overall, the most popular On Google Play, the app that appeared as the top result for both mobile app content was primarily focused on information (strain search terms was Pot Farm - Grass Roots, a game that allowed classification, facts) and recreation (games), with cannabis players to grow and harvest virtual marijuana. Users could run recipes demonstrating popularity as well. In contrast, only one their own dispensaries to sell weed and connect with other app in our sample focused on cannabis addiction or treatment. gamers to trade weed. The app was free, had an average user The popularity of informational and recreational apps likely rating of 4.4 stars, and had 500,000-1,000,000 downloads. This reflects a growing societal acceptance of cannabis, which is also app was given 2 content codes: Social Media and Games. reflected in state laws that have become more favorable toward The Google Play app that appeared as the second result for the medical and recreational use in recent years. Indeed, Apple search term ªcannabisº was BudTrimmer - Weed and Cannabis, recently relaxed a policy in its App Store prohibiting a game in which a player swiped across the screen to slash buds cannabis-related social media apps, likely both reflective of and and collect points. The app was free, had an average user rating influencing the increasing acceptance of cannabis use as of 4.3 stars, and had 100,000-500,000 downloads. This app was something that connects a growing number of people [24]. To coded as a Game. our knowledge, this study is the first to describe the content of cannabis-related mobile apps. Updates are likely to show a The Google Play app that appeared as the second result for the larger number of apps and a continued focus on information search term ªmarijuanaº was Weedmaps. This app functioned and recreation if state laws and public attitudes toward cannabis as a dispensary finder that helped users connect to local medical continue to move in a favorable direction. or recreational dispensaries, medical marijuana doctors, and delivery services. Users could also access dispensary menus, Apps addressing addiction or cannabis cessation were strain reviews, and ªexclusive offers.º The app was free, had underrepresented in the most popular cannabis mobile apps. an average user rating of 4.2 stars, and had 1,000,000-5,000,000 This could in part reflect the low level of motivation among downloads. Coders gave this app 4 content codes: Medicinal non-treatment-seeking marijuana users to cut down or quit use Use, Strain Classification, Dispensaries, and Facts. [25]. It also could reflect a lack of interest among mobile phone users to seek out health-related or cessation apps pertaining to

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cannabis. Although there is some evidence that a majority (57%) or ªcannabisº search terms on the Apple App Store, but not in of clients in drug treatment have mobile phones [26], there is the top 20 on Google Play. Leafly Marijuana Strain and limited evidence about the desire of persons in treatment to use Dispensary Reviews and Weedmaps were in the top 20 in both apps for therapeutic purposes and about the effectiveness of stores using all 4 search terms, indicating popularity among mobile apps for cannabis treatment. We found two published users of both types of devices. Both apps provide a resource for studies that showed promise in the use of mobile technology to those looking to classify different types of cannabis and locate treat cannabis use disorders: one using an ecological momentary dispensaries. intervention to monitor substance use among youth after a treatment episode [27]; and another testing the usability of an Limitations app to monitor and reduce cannabis use (Assess Plan Track It was not possible to link app content to user data. Further, Tips) [28]. As apps are developed, if evidence mounts as to search criteria were generated by using common words related their success in aiding behavior change, it is possible that these to cannabis (ie, ªcannabisº and ªmarijuanaº); however, users apps could become a reliable source of cannabis education or who are seeking a particular type of app may search directly cessation interventions. Health departments and other prominent for that app type (eg, ªcannabis treatmentº), which would not health organizations should consider creating or endorsing have been captured by this analysis and would likely yield accurate and evidence-based cannabis mobile apps to give them different results. Surveys of cannabis app seekers would be credibility in the ever-expanding app marketplace. useful to clarify this further. The decision to rate the top 20 app results for each search term was based on the authors'judgment The top apps for iPhone tend to provide information (eg, strains that this would encompass apps seen by a user during most of cannabis) or have some educational purpose, while top searches. The logic was that most users would not go beyond Android apps tend to be primarily for entertainment (games, approximately 1-2 screens on a desktop computer and even phone utilities). These differences likely reflect differences fewer results on a mobile device, for which fewer results are between iPhone and Android developers, who often program available on a single screen. A different method, incorporating an app for only one platform, and the platforms themselves more apps, would likely have yielded different results. The dictate app content based on rules/approval. For example, the content analysis is based on search results found in November Android market is perceived to be easier to enter than the Apple 2014. The app marketplace is changing rapidly; therefore, apps market because of fewer restrictions [6]; scrutiny may be that appeared at the top of search at the time of the study may particularly strong for approving cannabis apps in the Apple no longer be top apps in the future. App Store [29]. Conclusions Although we could not link user data to app characteristics in this analysis, market research has suggested that while Android Cannabis mobile apps are numerous and the most popular apps has a larger user base, iPhone users in the United States are focus on information, classification, and recreation (eg, games), younger and more affluent, engage with a larger amount of consistent with the expanding business of growing and selling mobile phone content, and are more likely to engage in mobile cannabis in the United States. Notably absent from the most commerce [30]. Future investigations should directly survey popular apps were those addressing the important public health mobile users about their use of cannabis apps on both Apple concern of cannabis addiction or negative health effects, for and Android operating systems to determine potential which mobile apps could be useful. Finally, there are notable implications for user activity. Of the 59 apps coded for this differences among apps on Apple's App Store and Google Play, project, 8 were available on both platforms (Apple and Android). likely reflecting the population of users, developer choice, and Of those 8, 6 were in the top 20 apps under either ªmarijuanaº platform regulations.

Acknowledgments This project was supported by a career development award from the National Institute on Drug Abuse (NIDA; K23 DA032578) and a Pathway to Independence Award from the National Cancer Institute (NCI; K99 CA187460). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Rachel Grana is now at the National Cancer Institute. Kathryn Chavez is now at Boston University. We would like to thank Shivali Gupta for her work on developing the coding guide and coding apps, and Howard Liu for conducting a literature review.

Authors© Contributions Dr Ramo designed the study with consultation from Drs Popova and Grana and Ms Chavez. Dr Ramo supervised the coding, and Dr Ramo and Ms Zhao conducted the analysis and drafted the manuscript. Drs Popova and Grana reviewed and revised subsequent drafts of the manuscript.

Conflicts of Interest None declared.

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Multimedia Appendix 1 Screenshots of apps representing each content area coded. [PDF File (Adobe PDF File), 727KB-Multimedia Appendix 1]

Multimedia Appendix 2 List of mobile apps analyzed (N=59) in order of popularity. [PDF File (Adobe PDF File), 32KB-Multimedia Appendix 2]

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Edited by G Eysenbach; submitted 06.03.15; peer-reviewed by M Lim, J Milward; comments to author 07.04.15; revised version received 27.05.15; accepted 13.07.15; published 12.08.15 Please cite as: Ramo DE, Popova L, Grana R, Zhao S, Chavez K Cannabis Mobile Apps: A Content Analysis JMIR mHealth uHealth 2015;3(3):e81 URL: http://mhealth.jmir.org/2015/3/e81/ doi: 10.2196/mhealth.4405 PMID: 26268634

©Danielle E Ramo, Lucy Popova, Rachel Grana, Shirley Zhao, Kathryn Chavez. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 12.08.2015. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

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